AudiologyOnline Phone: 800-753-2160


InnoCaption - Connected - July 2024

ENG Test Administration

Charles W. Stockwell, PhD

November 10, 2003

Share:

Question

What is the proper way to administer the spontaneous, gaze right, gaze left and positional tests? Should tasking be used in the eyes closed portion? What directions should be used for the OPK test? What is considered an abnormal OPK?

Answer

Different people would give different answers to your first question. I perform the gaze test (called the ''spontaneous nystagmus test'' in the code book) by asking the patient to look 30 deg to the right, 30 deg to the left, 30 deg up, and 30 deg down with eyes open. Some people also test with the patient's eyes closed, but I find the results hard to interpret. Some people also test with the patient's eyes at center gaze, but I consider this to be part of the positional test. I perform the positional test (called ''the positional nystagmus test'' in the code book) with the patient in the sitting, supine, right-ear-down, and left-ear-down positions with eyes open at center gaze and eyes closed. Some people test in the right-side-down position instead of the right-ear-down position and in the left-side-down position instead of the left-ear-down position. I test in the right-side-down and/or left-side-down positions (to check for nystagmus induced by neck rotation) only if nystagmus is elicited by right-ear-down and/or left-ear-down positions. Some people also test in the head hanging position. I also perform the right and left Dix-Hallpike maneuver, and if the Dix-Hallpike maneuver elicits horizontal nystagmus, I perform the roll test to check for horizontal canal BPPV. Some people don't perform the Dix-Hallpike maneuver or the roll test.

Tasking should always be used when testing with the patient's eyes closed.

I don't give specific instructions for the OPK test at first, but if the patient doesn't follow the targets very well, I may ask him or her to count the targets as they go by or to pick a target and follow it all the way across.

OPK nystagmus with slow phase velocities of less than 80% of target velocity is generally considered abnormal. The response may be abnormal for one or both directions of target motion.

Charles Stockwell

Bio:

Charles W. Stockwell, Ph.D., earned his doctorate in psychology at the University of Illinois in 1968. Currently president of Charles W. Stockwell & Associates, a consulting firm he established in 1990, Dr. Stockwell's professional career spans academia and clinical practice. From 1986 to 1996, he was director of the vestibular laboratory at Providence Hospital in Southfield, Michigan. Prior to that, Dr. Stockwell was a professor in the departments of otolaryngology and audiology at Wayne State University, in Detroit. And, from 1972 through 1884, he advanced from assistant professor to professor in the departments of otolaryngology and communication at Ohio State University. Dr. Stockwell has authored two books, Manual of Electronystagmography and ENG Workbook, and contributed chapters to numerous others. He has published more than 40 papers in peer-reviewed journals and conference proceedings and has made more than 120 presentations at scientific meetings or continuing medical education courses.

 


Charles W. Stockwell, PhD


Related Courses

Addressing Fall Risk: PT, OT, and Audiology Assessment and Intervention, presented in partnership with Salus University
Presented by Bre Myers, AuD, PhD, Helena Esmonde, PT, DPT, NCS, Anna Grasso, OTD
Recorded Webinar
AudiologyOnline

Presenters

Bre Myers, AuD, PhDHelena Esmonde, PT, DPT, NCSAnna Grasso, OTD
Course: #38144Level: Intermediate3 Hours
  'It was really helpful to learn more about fall risk assessment and treatment from different healthcare perspectives'   Read Reviews
Multidisciplinary assessment and intervention of individuals at risk of falls is crucial in identifying functional and diagnostic factors as well as effective rehabilitation and prevention of future falls. This series identifies areas of collaboration and supportive information-sharing strategies between professions who commonly see individuals who fall and are likely to be injured due to a fall.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

Contemporary Concepts in Pediatric Vestibular Assessment and Management, presented in partnership with Seminars in Hearing
Presented by Sharon Cushing, MD, FRCSC, Katheryn Bachmann, PhD, Violette Lavender, AuD, Jennifer B. Christy, PhD, PT, Steven M. Doettl, AuD, PhD, Devin L. McCaslin, PhD, Kristen L. Janky, PhD, Amanda I. Rodriguez, PhD, AuD
Recorded Webinar
AudiologyOnline

Presenters

Sharon Cushing, MD, FRCSCKatheryn Bachmann, PhDViolette Lavender, AuDJennifer B. Christy, PhD, PTSteven M. Doettl, AuD, PhDDevin L. McCaslin, PhDKristen L. Janky, PhDAmanda I. Rodriguez, PhD, AuD
Course: #35586Level: Intermediate5 Hours
This 5-part webinar series is focused on the growing evidence of the need for pediatric vestibular evaluation, as well as the availability of successful treatment options for children. Guest editors, Dr. Devin McCaslin and Dr. Jennifer Christy along with a team of leading experts will present on select articles from a recent issue of the journal Seminars in Hearing (Issue 03 · Volume 39 · 2018).

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

Quantitative Vestibular Function Testing in the Pediatric Population, presented in partnership with Seminars in Hearing
Presented by Kristen L. Janky, PhD, Amanda I. Rodriguez, PhD, AuD
Recorded Webinar
AudiologyOnline

Presenters

Kristen L. Janky, PhDAmanda I. Rodriguez, PhD, AuD
Course: #35334Level: Intermediate1 Hour
  'The presenters were excellent'   Read Reviews
The purpose of this presentation is to provide an overview of how to perform vestibular tests in children, including which tests are recommended based on the child’s age and any modifications or considerations that can be made.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

Preview of the University of Pittsburgh Teaching Vestibular Assessment and Rehabilitation across the Lifespan Conference
Presented by Catherine Palmer, PhD, Devin L. McCaslin, PhD, Patricia Gaffney, AuD, David Jedlicka, AuD, Sam Bittel, AuD, Virginia Milne, AuD, Elaine Mormer, PhD
Recorded Webinar
AudiologyOnline

Presenters

Catherine Palmer, PhDDevin L. McCaslin, PhDPatricia Gaffney, AuDDavid Jedlicka, AuDSam Bittel, AuDVirginia Milne, AuDElaine Mormer, PhD
Course: #32520Level: Introductory1 Hour
  'Pittsburgh focused'   Read Reviews
This course will present 5 topics critical to classroom and clinical teaching in the area of vestibular assessment and rehabilitation. This is a preview to the University of Pittsburgh Teaching Conference being held June 13-15, 2019.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

Minimum Stimulus Strategy in the Diagnosis of BPPV
Presented by Andrea Castellucci, MD
Recorded Webinar
INVENTIS • Audiology & Balance Equipment

Presenter

Andrea Castellucci, MD
Course: #39433Level: Intermediate2 Hours
  'would have been helpful to know more about the patients presenting symptoms'   Read Reviews
Benign Paroxysmal Positional Vertigo (BPPV) is the most common inner ear disorder, with a cumulative lifetime incidence of 10%. This course will cover the Minimum Stimulus Strategy (MSS), a nystagmus-based approach to streamline BPPV management, reducing the need for diagnostic and therapeutic maneuvers and minimizing patient discomfort.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

Our site uses cookies to improve your experience. By using our site, you agree to our Privacy Policy.